BOSTON -- Describing a foster care system rife with problems that could lead “risks to become realities,” Auditor Suzanne Bump released a critical review of the state’s foster care agency on Wednesday, stating that “significant management deficiencies” led to undocumented background checks on foster parents and poor oversight of medical treatment for children in state custody.

The audit produced by Bump’s office covered a period from July 2010 through September 2012, before the disappearance of a 5-year-old Fitchburg boy, who is presumed dead, that touched off a series of inquiries exposing deep problems at the Department of Children and Families with caseloads and oversight of children in its care.

“DCF does indeed work miracles on a daily basis. It is, however, an agency whose frontline workers and managers need better guidance and better tools in order to effectively protect children entrusted to their care,” Bump said at a press conference in her office where she described the report and said auditors began their work more than a year ago.

The report was released as lawmakers consider spending increases to address social worker caseloads and needs and while they await a full report on the agency by the Child Welfare League of America.

The audit found that DCF had not updated its department-wide risk assessment since 2008 which may be preventing the agency from identifying significant risks to foster children. Bump also said DCF workers did not have access to critical information in order to ensure that children receive the required seven-day medical screenings and 30-day medical examinations once they have been placed in state custody, and managers aware of the problems failed to react to the situation.

Additionally, DCF maintained incomplete records of background checks performed on adults living in foster homes and had not been conducting checks for the proximity of Level 2 and Level 3 registered sex offenders before placing children in foster homes.

“The findings in our audit today constitute more than record keeping problems at the agency. It’s inability to ensure that medical screenings of children and background checks of foster placements are taking place is symptomatic of an agency whose employees are without ready access to the information, technology and guidance they need in order to protect the children and the families that they serves,” Bump said. “DCF needs help to do its job.”

Page 2 of 3 - Bump said she has initiated a follow-up audit to examine the process for granting background check waivers to foster homes with adults who may have a criminal record because DCF was unable to provide auditors with a complete list of placements in homes where waivers had been issued.

Bump reported that some of her recommendations for improvements at the agency are already being implemented, and the department responded to the release of the her audit by detailing the new practices in place to ensure children in foster care receive timely medical screening and background checks on employees and foster homes.

The agency said that a separate Medicaid review showed that 90 percent of children received medical care within 30 days before or after placement in foster care, and that the department has started sharing information between Medicaid and improving documentation of medical visits.

DCF also said it is now conducting background checks and sex-offender registry checks on all applicants for foster care and adoption, and verified that no children in foster care are living with sex offenders, though the auditor’s report found that some children are living in the same building as Level 3 offenders.

“We are working day-in and day-out to enhance our ability to protect children and strengthen families, “DCF Commissioner Olga Roche said in a statement. “Working with our partners to improve services and providing field staff with the resources they need is central to achieving our agency’s mission.”

Gov. Deval Patrick had a reserved response to the auditor’s findings, many of which have also been identified by the Child Welfare League of America who Patrick hired to review the agency.

“I don’t think there really is really anything new there. It’s mostly technical and about record-keeping, for example the issues of children getting their initial medical screenings, or those records being kept at DCF or over at MassHealth,” Patrick told reporters, when asked about the report. “The larger issues at DCF remain. The auditor’s report didn’t really get into that – and those are around staffing and technology and we’re working on that.”Patrick also said some news accounts of a Cape Cod runaway and a Mattapan murder victim, both of whom were involved to an extent with DCF, were examples of the agency working well yet unable to prevent difficult situations.“I’m sorry to say that is part of what happens in child welfare. It’s not that it’s acceptable, but like I’ve said many, many times before, the folks at DCF and in child welfare agencies all over the country work with some of the most troubling children and some of the most troubling situations, and not every outcome is a happy one,” Patrick said.

Page 3 of 3 - Though Bump sidestepped questions about Roche’s ability to lead the agency and said her audit was about correcting systematic issues within the entire agency, Republican gubernatorial candidate Charlie Baker said the audit showed why “putting new leadership in place is the first step in fixing this broken agency.”

Patrick has stood behind Roche’s ability to continue to lead and improve DCF.

Senate Minority Leader Bruce Tarr said Bump’s audit “reconfirms the risks posed to vulnerable children” because of problems with the management of the Department of Children and Families.

“Now, more than ever, it is clear that reforming this agency needs to be a priority for the Legislature and the Administration, and the job needs to be done in a timely and effective way,” Tarr said.

The union representing social workers, who recently began circulating a letter questioning the efficacy of communications and directives from senior managers in the agency, said it wished Bump had consulted with them in the course of her audit. Bump said she is restricted by auditing practices about who she can share information with, but assured reporters that problems uncovered were brought immediately to management for action.

“Had the State Auditor formally engaged front-line workers in the audit process, this report would have identified today's real barriers to successful child protection – from the worsening caseload crisis to disjointed implementation of key directives and policies. We hope that future audits will incorporate this experience and expertise to better reflect the realities of on-the-ground child protection work,” SEIU Local 509 spokesman Jason Stephany said.